Wednesday, March 31, 2010

The Ideal Birth

Do you ever wonder if the natural birth community over-idealise the drug-free natural vaginal birth? The reason I say this is that as a home-birthing mama, I've lately begun to feel some of my own performance anxiety when I read other people's drug-free labour tales. And I'm not the only one: Betsy B. Honest has written a brilliant blog post on birth performance anxiety.

I like to do well at whatever I try; maybe it's because my parents praised me too much (or maybe not enough). It seems faintly ridiculous that anyone should feel pressure to "do well" at birth. Yet I think I speak for more than just myself when I say that we do feel this pressure to have the "right" kind of birth. I used gas and air to help me deal with the most painful part of the first stage of my labour; does that mean I am in any way inferior to someone who manages without any pain relief at all? I don't think so. But the natural birthing community does celebrate the drug-free home birth above all other ways of birthing. They don't mean to say that other ways are less good, but that is perhaps the message that they give.

A "good" birth is one on which the mother and baby are healthy, alert, unharmed and happy. This is physically best for the baby, enables the mother to recover quickly and gives them the best possible chance of establishing breastfeeding successfully. A drug-free home birth certainly achieves this, but it is not the only way. Sometimes mothers feel safer in hospitals and sometimes it is best that they are there just in case something goes wrong. Sometimes the judicious and timely use of pain medication may enable a mother to have the birth she desires. I am not ignoring the fact that the use of pain relief can trigger a "spiral of intervention", but sometimes it can help rather than hinder. Here is a lovely birth story of a lady who says that without pain relief and hypnobirthing to help her through a long and difficult back labour, she believes she would have ended up having a c-section.

Do you remember a couple of years ago when the press blamed the pressure to breastfeed on a woman's suicide? It was a typical piece of media sensationalism but the truth is that breastfeeding difficulties (not pressure to breastfeed) can contribute to the emergence of post-natal depression. A traumatic birth can equally lead to PND. I wonder if a failure of the childbirth experience to live up to the longed-for "ideal" can also contribute to depression?

All I am saying is that if we raise women's expectations of birth too high, they are more likely to be disappointed with their real-life experiences. Midwives tell us to expect the unexpected, and though I believe strongly that women should prepare and plan for a natural birth, it is also necessary to understand that sometimes things don't go to plan. Painful and dangerous childbirth is a consequence of our babies' large heads and our bipedalism, and it is only our large intelligent brains that have allowed us to develop methods to overcome the dangers inherent in human childbirth and reduce the maternal death rate. So I think it is wrong to assume that all interventions are automatically "unnatural". I am sure that humans have been looking for ways to ease our babies' paths into the world for as long as we have been on the earth.

Perhaps all I really want to say is that the drug-free home birthing experience is great if that's what you want, but that other satisfying birth experiences should be valued equally highly. Anything that is healthy for mother and baby should be celebrated.


cartside said...

Excellent post. I really wanted a natural birth and looking back I think I would have avoided almost having a c-section if I had had an epidural - plus I felt like a failure for a full year until I finally accepted that really all that matters is that all went well. Yes, i'd love to have a drug free home birth,

ILikePaperCutting said...

This is an interesting site. I read about your co-sleeping & family bed. I am doing it but I wasn't know that I am doing the right thing. Thanks for those great posts.

Betsy B. Honest said...

I'm glad my earlier post resonated with you.

I agree with everything you've said here.

I think birth should be about women making their own informed choices about what's best for them and their babies.

And never about some perscriptive the-best-birth pissing contest.

Lisa C said...

"Anything that is healthy for mother and baby should be celebrated."

Things that bug me are things like when choices are made for "convenience" instead of really what is healthiest. I also think that most women do not fully understand their options nor the risks of medical interventions. I fully support INFORMED choices that are made with the health of the mother and baby in mind.

That said, I also don't believe any woman should feel inferior or guilty for asking for pain relief (I didn't want to use an epidural, but when it came down to it, I gave myself permission to have one and didn't feel guilty about it). Nor for any other choice she makes about childbirth. As long as they are choosing what they believe is healthiest, good for them.

Kate said...

My water broke 42 hours before I had my daughter. I was in the hospital, but I brought a ton of my own things: pillow, blanket, soothing music, my own night gown. I had minimal intervention, but had to fight it the whole way. I was told that if by 36 hours I hadn't delivered, I most likely would have to have a c-section.
My midwife fought for me, but in the end I did agree to pitocin. I made a compromise. I went with out an epidural and had her vaginally. I attribute my choices and the success of her healthy birth to my knowledge of my options, as well as, a midwife who stayed by my side and supported those choices.

Lauren @ Hobo Mama said...

Very true. There are so many factors that go into any one birthing experience that it's folly (or arrogance?) to say that only one type of birth is valid or virtuous.

I didn't like it when people told me that a healthy baby and a healthy me were all that mattered, since I did need to grieve my lost expectations — but maybe you're right that having those expectations in the first place was setting me up almost inevitably for postpartum guilt and sorrow. I definitely don't think any mother should feel ashamed of choices she made in the heat of the moment and under the influence of incredible physical and emotional torrents.

Cave Mother said...

Lauren - it annoys me when people say that a healthy baby is all that matters. I wish it was all that mattered, but the fact is that omen are left scarred and traumatised, or at least regretful, over poorly handled births. I definitely think there's a case for expectation management though.

Thanks for all the comments. I always worry that people are going to totally shoot me down when I post things like this!